A recently completed large database of fish tissue contamination in resident and anadromous Columbia River fish indicates that risks greatly exceed acceptable levels for tribal members whose culture and subsistence depends on those fish, even at the lowest fish consumption levels. However, reducing fish consumption has serious cultural consequences of its own, so intervention is not simply a matter of issuing advisories. This proposal will provide a model response from within the community tailored to the needs and size of the Yakama Nation. The applicants' educational goals are to educate other Yakama Nation Indian Health Service (IHS) healthcare providers about the contamination, develop culturally appropriate educational and/or advisory materials for tribal members and policy makers, evaluate the understanding of the materials in the general membership, and develop educational materials for state and federal agencies that explain the cultural consequences of the contamination. Their research goals are to establish a Yakama Nation Institutional Review Board that monitors anticipated university-based research requests and internally generated studies, to examine existing health statistics and compare them to predicted effects of contaminants (and other research strategies), and to develop research goals. The healthcare goals are to develop and provide culturally appropriate healthcare and educational intervention at the IHS clinic and evaluate changes in health behavior or health indicators. The capacity-building goals are to develop a Yakama Environmental Health Plan based on an environmental health needs assessment, provide all materials to nearby tribes through the Columbia River Intertribal Fish Commission to use or modify according to their needs, and to build trust through university ties in anticipation of future partnerships and collaborations.